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The aim of this study was to compare the clinical and imaging characteristics of osteosarcoma and Ewing sarcoma in children and adolescents. The examination results of 108 patients, including 58 with osteosarcoma and 50 with Ewing sarcoma, were analyzed descriptively. Age, sex, tumor location, growth pattern, margins, type of bone destruction, periosteal reaction, soft tissue component, edema, bone marrow involvement, and metastases were assessed. Osteosarcoma was more frequently detected in the older age group, whereas Ewing sarcoma showed a more uniform age distribution. Femoral involvement, mixed growth patterns, and irregular margins predominated in both groups. Spiculated periosteal reactions and osteoplastic components were more common in osteosarcoma, while lytic patterns and onion-skin periosteal reactions were more characteristic of Ewing sarcoma. The findings provide guidance for differential diagnosis; however, the descriptive study design, missing data, and lack of statistical testing preclude assessment of the diagnostic accuracy of individual features.
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Yusupalieva et al. (2026) studied this question.
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